In order to facilitate the viewing and analysis of biomedical images, the Clinical Center is in the process of designing and developing an Image Management System (IMS) to complement the current text-based Medical Information System (MIS). This new system will consist of the following four key components: (1) several different types of medical image gateways (MIGs) ; (2) an image archival and retrieval system (IARS) that has an MIS interface; (3) several different types of workstations (WS) possessing a common biomedical shell; and (4) an interconnecting communications network. The MIGs will permit digital radiological images (i.e., MR, CT, PET, etc.), nondigital radiological images (i.e., plane-film X ray), and nonradiological images (i.e., video-microscopic images, EKG tracings, patient monitor information, etc.) to be converted to a common format, compressed without loss, and automatically sent to the IARS. The IARS will permit not only the long-term archiving on optical media of the images coming from the MIGs, but also the retrieval of multiple modality images to local workstations in response to queries via the existing MIS data base, the new IMS data base, or individual departmental data bases. In the workstation area, we will be developing two or three different types of biomedical workstations. The key to this series of workstations is that they would utilize the same biomedical shell (i.e., user interface). Application programs for diagnostic imaging, stereotaxic surgical planning, radiation therapy planning, tumor staging, etc., will also be developed.